MJDF Pharmacology & Pain Control 2

Question 1

Which analgesic combination is recommended by NICE for post-operative dental pain in adults without contraindications?

Accepted Answer

Ibuprofen 400 mg + paracetamol 1 g (alternating or combined)

Answer

Evidence supports the combination of an NSAID (ibuprofen 400 mg) with paracetamol 1 g for dental pain, providing superior analgesia through complementary mechanisms compared to either drug alone.

Question 2

What is the mechanism of action of NSAIDs in dental pain management?

Accepted Answer

Inhibit COX-1 and COX-2, reducing prostaglandin synthesis at the site of inflammation

Answer

NSAIDs (e.g., ibuprofen) inhibit cyclo-oxygenase enzymes (COX-1/COX-2), reducing prostaglandin production at sites of dental/periodontal inflammation, thereby reducing pain and swelling.

Question 3

What drug interaction must be considered when prescribing metronidazole to a dental patient?

Accepted Answer

Metronidazole inhibits aldehyde dehydrogenase — serious interaction with alcohol (disulfiram-like reaction)

Answer

Metronidazole inhibits alcohol metabolism, causing acetaldehyde accumulation; patients must be warned to avoid alcohol during and for 48 hours after the course due to the severe disulfiram-like reaction.

Question 4

What is the first-line antibiotic for acute dentoalveolar abscess in a non-penicillin-allergic patient?

Accepted Answer

Amoxicillin 500 mg three times daily for 5 days

Answer

Amoxicillin 500 mg TDS for 5 days is the first-line antibiotic for acute dentoalveolar abscess when systemic signs are present and drainage alone is insufficient, per PHE antimicrobial guidelines.

Question 5

What is the mechanism of action of midazolam in conscious sedation?

Accepted Answer

Positive allosteric modulator of GABA-A receptors, enhancing chloride channel opening (CNS depression)

Answer

Midazolam (a benzodiazepine) binds allosterically to GABA-A receptors, increasing frequency of chloride channel opening in response to GABA, producing anxiolysis, amnesia, and sedation.

MJDF Part 1 Practice Test

MJDF Part 1 Practice Test

MJDF Pharmacology & Pain Control 2